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Baby Formula

Baby formula, or infant formula, is a breast milk substitute designed to feed children less than 12 months of age. Formulas are typically powders designed to be mixed with liquid for bottle-feeding. They contain all the nutrition a baby needs and may be made of cow’s milk or non-dairy alternatives.

Last Modified: March 28, 2024
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What Are the Main Types of Baby Formula?

Baby formulas come in three main types: Cow’s milk formula, soy formula and specialized formula. These formulas are available in three forms: Powder you mix with water, liquid concentrate you mix with water and formulas that don’t require mixing that come in ready-to-feed bottles.

The U.S. Food and Drug Administration regulates the contents and safe production of all infant formulas sold in the U.S., and all formulas have to contain sufficient nutrition, including iron.

Cow’s Milk-Based Formulas

These formulas make up about 80% of all formulas sold. The cow’s milk in the formula is treated to make the protein more digestible, and milk sugar (lactose) is added to make it more equal to breast milk. Vegetable oil replaces the butterfat so infants can more easily digest it.

Soy-Based Formulas

These formulas use soy proteins and do not contain lactose. These formulas may help babies allergic to lactose found in cow’s milk. According to the American Academy of Pediatrics (AAP), up to 50% of babies allergic to milk protein may also be sensitive to soy protein.

Specialized Formulas

Designed for babies with certain conditions, these specialized formulas should not be used without your pediatrician’s recommendation. These include premature baby, or preemie, formulas specifically designed for preterm infants and hypoallergenic amino acid-based formulas.

What Is Hypoallergenic Baby Formula?

Manufacturers designed hypoallergenic baby formula for babies with food intolerances and allergies to proteins found in cow’s milk. Cow’s milk protein intolerance is one of the most common food allergies.

Even if hypoallergenic baby formula is designed for babies with allergies, some babies may still react to it. In these cases, parents and caregivers should speak to their baby’s medical provider for more health information and to find a suitable replacement.

Types of Hypoallergenic Baby Formulas

There are three types of hypoallergenic baby formulas: partially hydrolyzed, extensively hydrolyzed and amino acid-based formulas. These are classified by how the proteins are processed, and all types contain complete nutrition for infants.

Experts caution that partially hydrolyzed formulas aren’t truly hypoallergenic and could still cause significant reactions. They are not used for babies with cow’s milk allergies.

Extensively hydrolyzed formulas break down casein, the protein found in cow’s milk, into smaller pieces that babies can tolerate. This process pre-digests cow’s milk proteins and makes protein particles very small, making them less likely to trigger allergies.

About 90% of babies who are allergic to cow’s milk can tolerate extensively hydrolyzed formulas.

Babies who can’t tolerate extensively hydrolyzed formulas are more likely to do well with amino acid-based baby formula. These formulas, also called elemental formulas, are made of the basic building blocks of protein called amino acids. The formulas are suitable for babies with cow’s milk allergy and soy allergies.

What Is Preemie Baby Formula?

Preemie formula is designed to provide more nutrients, protein and vitamins than regular baby formula to help a preemie grow and gain weight. Preemie formula is effective, but it also comes with a higher risk of necrotizing enterocolitis (NEC), a potentially fatal intestinal disease.

Types of Preemie Formulas

Not all babies will respond well to standard preemie formulas, and there are different types of baby formulas to fit a baby’s special needs. You shouldn’t use homemade baby formula because it may not be safe and babies must receive all the nutrition they need.

Preemies may be more prone to digestive issues than full-term infants. For example, preemies may develop a cow’s milk allergy and most standard formulas are made with cow’s milk. In these cases, a pediatrician may recommend a special type of non-dairy formula.

Special types of preemie baby formula might be amino acid-based, lactose-free and hypoallergenic. If a special baby formula isn’t made specifically for preemies, doctors may also suggest adding a formula fortifier.

Preemie Formula Options
Amino Acid-Based Formula
Amino acid-based formulas are recommended for preterm infants with cow’s milk allergies or trouble digesting fat. These formulas use simple proteins called amino acids instead of protein from milk. Popular brands include EleCare, Enfamil Nutramigen AA and Neocate.
Lactose-Free Formula
Preemies who can’t digest lactose, the sugars in cow’s milk, may benefit from a lactose-free formula. However, some formulas do not contain lactose but still made from dairy proteins. Babies with a cow’s milk allergy may still have trouble with lactose-free formulas that contain dairy proteins. In some cases, using a soy-based formula may help. Popular lactose-free brands include Similac Sensitive and Enfamil LactoFree.
Hypoallergenic Formula
Hypoallergenic baby formula is designed for babies who have soy and cow’s milk allergies. Studies have shown hypoallergenic formula prevents atopic disease and treats milk protein allergies in high-risk infants. Popular brands include Similac Alimentum and Enfamil Nutramigen.

The AAP and other experts recommend breastfeeding as the optimal way to nourish your baby. However, some women might not be able to breastfeed for various reasons. Manufactured baby formula hasn’t been able to completely match breastmilk. But some brands such as Enfamil and Similac add ingredients like probiotics and Lactoferrin, a key component of breastmilk, and claim they are “close to breastmilk.”

However, parents are filing baby formula lawsuits after their premature babies developed necrotizing enterocolitis (NEC) after consuming Enfamil and Similac cow’s milk-based formulas. NEC is a potential baby formula side effect that causes intestinal inflammation and can lead to tissue death and blood infections. NEC can be fatal.

Lawsuit Information
Lawsuits are being filed by parents whose children were diagnosed with necrotizing enterocolitis (NEC) after consuming cow's milk-based formula. Learn more.
View Lawsuits

How To Choose the Best Baby Formula for Your Child

Always consult your pediatrician when it comes to choosing the best formula for your child. Most experts recommend cow’s milk formula over other types, unless a baby has a special condition. A parent’s formula choice is usually unique to the baby’s needs and your budget.

When feeding your baby, make sure to look out for signs of milk or food allergies. Symptoms include: Breathing problems, coughing, diarrhea, vomiting, hives and itchy eyes. If your baby has food allergies, you will want to opt for a formula that is hydrolyzed or amino acid-based. Your doctor can recommend a good brand.

“There is no compelling evidence that for otherwise well infants, any one formula is going to be better for any particular infant than any other available formula.”

Brand name or generic versions are similar in ingredients, but the generic version will be less expensive. Organic formulas have to follow the same baby formula standards as non-organic brands but they don’t contain GMOs and have certified organic ingredients. This means they are usually more expensive.

Most experts agree that there is no good evidence that shows which formula is best or that one formula is better than another. But CDC cautions against using homemade baby formulas or formulas purchased online from third party distributors because these formulas are not regulated by the FDA and might not be safe or nutritionally complete.

How Much Formula Should a Baby Drink?

How much formula to feed a baby is unique to each baby. The average baby should take about two and a half ounces of formula a day for every pound of body weight, according to the APP. The CDC recommends feeding your baby when they are hungry and stopping when they are full.

Signs of hunger include: Putting hands in mouth, licking lips, clenching hands, showing excitement when food is around or turning toward the bottle. Signs of fullness include: Closing the mouth, turning away from the bottle, relaxing hands, pushing food away or making noises to let you know they are full.

How Much Formula and How Often to Feed Babies
AgeAmountHow Often
First Days 1 to 2 ouncesEvery 2 to 3 hours
First Weeks and MonthsBabies take what they need and stop eating when fullEvery 3 to 4 hours
Six to 12 MonthsFeed when baby shows signs of hunger. Feedings may be infant formula or solid foodsFive to six times in 24 hours

You should give a baby formula until they are about a year old, according to the CDC. After 12 months, babies can transition to solid foods and whole cow’s milk or unsweetened soy beverage.

The switch away from formula should be gradual. Parents can start replacing one formula feeding with cow’s milk and gradually decrease the formula feedings.

How Long Does Baby Formula Last?

Unopened containers of baby formula will last until the expiration date on the package. Make sure you don’t use expired baby formula. You should store unopened containers in a cool, dry place indoors.

Cronobacter is a germ that can be found in powdered infant formula. These infections may be deadly to babies. Make sure to thoroughly clean bottles and formula lids and scoops to avoid contamination.

You should use prepared baby formula within two hours. Infant formula not used within two hours can last up to 24 hours in the refrigerator. Throw away any leftover formula your baby doesn’t eat because baby saliva mixed with formula may cause bacteria to grow and cause side effects and health problems.

Opened containers of baby formula typically last about one month. Make sure to label opened formula containers with dates to prevent using old formula.

2022 Baby Formula Recall & Shortages

In February 2022, Abbott Nutrition issued a recall on baby formula for Similac, Alimentum and EleCare powdered baby formulas after it received reports that five babies became sick with Cronobacter sakazakii and Salmonella Newport infections.

Each of the infected infants was hospitalized, and two babies may have died from their infections.

In a preliminary inspection report from March 2022, FDA inspectors observed that Abbott didn’t have a system in place to ensure infant formula wouldn’t get contaminated with microorganisms.

This particular recall was not related to baby formula lawsuits claiming a link between Abbott’s baby formula and NEC.

Why Was There a Baby Formula Shortage?

In early 2022, American parents and child caregivers struggled to find baby formula on local store shelves. A “perfect storm” combination of COVID-19-related supply chain issues, the Abbott product recall announcement issued by the FDA and the shutdown of a major manufacturing plant led to a nationwide shortage of the baby formula millions of people rely on to feed their children.

The supply shortage peaked during the late spring and early summer months of 2022, and data from the U.S. Census Bureau’s Household Pulse Survey revealed that 50% of families with an infant under the age of 1 were still feeling the impact in late September.

In April 2022, Abbott released a statement addressing the baby formula shortage that its recall had exacerbated. The manufacturer told consumers it would increase production at its plants in Ohio and Ireland to combat the shortage.

In June 2022, the FDA reported another baby had died of a bacterial infection. In the same month, Abbott reopened its Sturgis, Michigan plant to help ease baby formula shortages.

Please seek the advice of a medical professional before making health care decisions.